Abstract

Two premature twins (33 weeks gestation) were born to a woman who had used paroxetine
during pregnancy for an anxiety-depression disorder. They were admitted to the NICU,
where they showed prolonged RDS, cardiovascular malformations, and facial dysmorphisms.
Soon after birth, they also presented abnormal neurobehavioral and motor signs, which
partially disappeared during the following weeks, although alterations of tone persisted
even at discharge.

Selective serotonin reuptake inhibitor (SSRI) antidepressants are considered the primary
treatments for depression and anxiety in pregnancy. Since intrauterine exposure to
these drugs has been associated with poor neonatal adaptation, low birth weight, RDS,
neurobehavioural symptoms, and potential teratogenic effects, further studies are
needed to assess risks and mechanism of action of SSRIs. Meanwhile, it is advisable
to evaluate for each patient the real risk/benefit ratio of continuing or suspending
treatment during pregnancy.